| NPI | 1528121209 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: ME 009832) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NH 6032) |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2010-07-09 |