| NPI | 1871855502 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: ME MD21891) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 2017-00044) |
| Enumeration Date | 2012-06-08 |
| Last Update Date | 2018-12-03 |