| NPI | 1821187667 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME105280) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VA 0101031712) |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: FL ME105280) | |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2018-12-18 |