| NPI | 1235129081 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 2007--00102) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME47550) |
| Enumeration Date | 2005-10-24 |
| Last Update Date | 2012-10-23 |