| NPI | 1306828793 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: FL ME0050420) |
| Additional Taxonomies | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: MA 57437) |
| 208100000X Physical Medicine & Rehabilitation (Licence: FL OS7098) | |
| Enumeration Date | 2005-11-19 |
| Last Update Date | 2008-12-17 |