| NPI | 1871757724 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 2017-01378) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME108467) |
| Enumeration Date | 2008-07-10 |
| Last Update Date | 2020-11-05 |