| NPI | 1841752391 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NH 34577) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: ME MD29318) |
| 207XX0004X Orthopaedic Surgery Foot and Ankle Surgery (Licence: NH 34577) | |
| 207XX0004X Orthopaedic Surgery Foot and Ankle Surgery (Licence: ME MD29318) | |
| Enumeration Date | 2019-04-03 |
| Last Update Date | 2025-08-26 |