| NPI | 1609969948 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: ME TD061101) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VA 0101017689) |
| 207X00000X Orthopaedic Surgery (Licence: DC 2783) | |
| Enumeration Date | 2006-10-01 |
| Last Update Date | 2007-07-08 |