| NPI | 1285669390 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME111701) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: LA 201054) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2013-06-27 |