| NPI | 1104044700 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 070040) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME111853) |
| Enumeration Date | 2007-04-22 |
| Last Update Date | 2018-08-10 |