| NPI | 1770677759 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MD D0027275)  | 
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME43996)  | 
| Enumeration Date | 2006-10-03 | 
| Last Update Date | 2010-03-18 |