| NPI | 1558385286 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME101434) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: GA 48878) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2013-10-31 |