| NPI | 1407977606 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: FL ME117442) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 49844) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2016-12-07 |