| NPI | 1942294095 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME165012) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 225344) |
| Enumeration Date | 2005-09-06 |
| Last Update Date | 2026-05-19 |