| NPI | 1669449575 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME110558) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: GA 055884) |
| Enumeration Date | 2006-03-01 |
| Last Update Date | 2016-04-29 |