| NPI | 1023011905 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME81354) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: GA 054463) |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2012-03-06 |