| NPI | 1891793469 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME140436) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA G78805) |
| Enumeration Date | 2005-07-08 |
| Last Update Date | 2022-08-10 |