| NPI | 1407083348 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A141816) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME124346) |
| Enumeration Date | 2009-06-18 |
| Last Update Date | 2016-10-20 |