| NPI | 1891750360 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NH 6067) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: ME 009855) |
| 207X00000X Orthopaedic Surgery (Licence: MI 0720966) | |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2007-07-08 |