| NPI | 1194845479 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CT 49852) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME102073) |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2018-06-05 |