| NPI | 1992027213 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MA 243828) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: ME MD24223) |
| Enumeration Date | 2010-03-01 |
| Last Update Date | 2021-02-09 |