| NPI | 1821350059 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME131508) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 182656) |
| Enumeration Date | 2012-06-13 |
| Last Update Date | 2022-07-21 |