| NPI | 1912964263 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NH 7386) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: ME 012297) |
| 207X00000X Orthopaedic Surgery (Licence: MA 47787) | |
| Enumeration Date | 2006-04-28 |
| Last Update Date | 2017-02-23 |