| NPI | 1245244102 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OH 35. 077125) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VT 042-0009424) |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2007-07-08 |