| NPI | 1841711819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME162570) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL TRN25573) |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: FL ME162570) | |
| Enumeration Date | 2017-06-29 |
| Last Update Date | 2024-11-11 |