| NPI | 1497749840 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: ME MD21337) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VT 0420009730) |
| Enumeration Date | 2005-08-31 |
| Last Update Date | 2019-01-11 |