| NPI | 1003895111 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: ME DO2241) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA OS-009940-L) |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2016-03-21 |