| NPI | 1841283132 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME0053867) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX L1829) |
| Enumeration Date | 2005-08-23 |
| Last Update Date | 2009-08-20 |