| NPI | 1912109034 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: ME MD20163) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: RI 13842) |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2014-06-06 |