| NPI | 1992786776 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME100433) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 218994) |
| Enumeration Date | 2005-11-09 |
| Last Update Date | 2019-10-23 |