| NPI | 1912987306 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME105667) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AZ 30241) |
| 207X00000X Orthopaedic Surgery (Licence: PA MD073529L) | |
| Enumeration Date | 2006-01-20 |
| Last Update Date | 2011-11-29 |