| NPI | 1184893190 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME124660) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 57.013325) |
| 207X00000X Orthopaedic Surgery (Licence: TN MD49918) | |
| Enumeration Date | 2008-02-23 |
| Last Update Date | 2017-04-21 |