| NPI | 1679708952 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: LA 208163) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME118589) |
| Enumeration Date | 2009-05-15 |
| Last Update Date | 2016-07-22 |