| NPI | 1124280862 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 003121) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME115924) |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2014-06-26 |