| NPI | 1578661286 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME99095) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 35087656) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2007-07-19 |