| NPI | 1093792657 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME0053136) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: FL ME0053136) |
| Enumeration Date | 2005-12-27 |
| Last Update Date | 2012-03-22 |