| NPI | 1306813035 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL 46349) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME46349) |
| Enumeration Date | 2006-03-01 |
| Last Update Date | 2012-06-12 |