| NPI | 1194934752 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AL 28579) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL ME120014) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2016-10-04 |