| NPI | 1982970539 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NH 19321) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: ME MD22626) |
| 207X00000X Orthopaedic Surgery (Licence: FL ME130912) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-03-28 |
| Last Update Date | 2019-03-08 |