| NPI | 1053586016 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OR MD153962) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME107071) |
| Enumeration Date | 2008-04-29 |
| Last Update Date | 2017-03-07 |