| NPI | 1215010566 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: ME 017743) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX K9732) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2011-12-29 |