| NPI | 1184659104 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: ME 017559) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 227762) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2019-10-11 |