| NPI | 1811996473 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME59693) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME0059693) |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: FL ME0059693) | |
| Enumeration Date | 2005-07-18 |
| Last Update Date | 2020-11-24 |