| NPI | 1306076948 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX Q5558) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME119172) |
| 207XX0801X Orthopaedic Surgery Orthopaedic Trauma (Licence: TX Q5558) | |
| Enumeration Date | 2009-07-16 |
| Last Update Date | 2015-10-06 |