| NPI | 1326167230 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME102328) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2003016151) |
| 207X00000X Orthopaedic Surgery (Licence: GA 060886) | |
| 207X00000X Orthopaedic Surgery (Licence: AL MD.28749) | |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2014-06-27 |