| NPI | 1811923105 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME63009) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL ME63009) |
| Enumeration Date | 2006-06-25 |
| Last Update Date | 2009-04-03 |