| NPI | 1255324679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME0066643) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TN 30473) |
| 207X00000X Orthopaedic Surgery (Licence: GA 045273) | |
| Enumeration Date | 2005-08-31 |
| Last Update Date | 2013-05-07 |