| NPI | 1942349949 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: FL ME131538) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME131538) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2021-03-25 |