| NPI | 1942408059 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME157639) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NY 245023) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: FL ME157639) | |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2024-05-21 |