| NPI | 1194715037 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WY 6940a) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 153414) |
| 207X00000X Orthopaedic Surgery (Licence: NH 10168) | |
| 207X00000X Orthopaedic Surgery (Licence: NC 95-00203) | |
| 207X00000X Orthopaedic Surgery (Licence: ME MD14964) | |
| Enumeration Date | 2005-10-23 |
| Last Update Date | 2013-11-05 |