| NPI | 1336477025 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME 021345) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX TM 00182) |
| Enumeration Date | 2009-11-18 |
| Last Update Date | 2009-11-18 |