| NPI | 1376700013 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 238949) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME 110931) |
| 207X00000X Orthopaedic Surgery (Licence: MD D69038) | |
| Enumeration Date | 2008-05-20 |
| Last Update Date | 2014-07-29 |