| NPI | 1134181605 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME47301) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME00047301) |
| 207X00000X Orthopaedic Surgery (Licence: TN 43119) | |
| Enumeration Date | 2006-04-03 |
| Last Update Date | 2011-07-26 |