| NPI | 1427029586 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME100834) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: ND 4223) |
| 207X00000X Orthopaedic Surgery (Licence: MN 22042) | |
| Enumeration Date | 2006-01-27 |
| Last Update Date | 2008-11-14 |