| NPI | 1366537284 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME0056557) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA G176044) |
| 207X00000X Orthopaedic Surgery (Licence: TX J0806) | |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2008-05-30 |