| NPI | 1972502961 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery (Licence: ME MD12797) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: ME MD12797) |
| Enumeration Date | 2005-07-20 |
| Last Update Date | 2025-06-24 |