| NPI | 1891809950 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME64942) |
| Additional Taxonomies | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: FL ME64942) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: FL ME64942) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL ME0064942) | |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2023-01-27 |