| NPI | 1891143095 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: NY 319598-01) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: ME LT22005) |
| 208D00000X General Practice (Licence: FL UO4916) | |
| 207X00000X Orthopaedic Surgery (Licence: FL OS18517) | |
| Enumeration Date | 2016-05-27 |
| Last Update Date | 2022-12-23 |