| NPI | 1013981653 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: FL ME55438) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME 55438) |
| Enumeration Date | 2006-02-13 |
| Last Update Date | 2007-08-09 |