| NPI | 1649251273 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: ME 012764) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL 88329) |
| Enumeration Date | 2005-11-10 |
| Last Update Date | 2015-01-21 |