| NPI | 1033558010 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WI 71467) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 5101020737) |
| Enumeration Date | 2013-06-23 |
| Last Update Date | 2023-11-17 |