| NPI | 1851852024 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: FL ME171583) |
| Additional Taxonomies | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: NC ME171583) |
| 207X00000X Orthopaedic Surgery (Licence: NC ME171583) | |
| 207X00000X Orthopaedic Surgery (Licence: FL ME171583) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: FL ME171583) | |
| Enumeration Date | 2019-03-28 |
| Last Update Date | 2025-10-18 |