| NPI | 1730165101 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME95650) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VA 0101057649) |
| Enumeration Date | 2005-12-19 |
| Last Update Date | 2010-10-15 |