| NPI | 1962637983 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: FL ME122996) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WI 2934-320) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-05-19 |
| Last Update Date | 2023-05-18 |