| NPI | 1033560032 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: KY TP876) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4301110822) |
| Enumeration Date | 2016-06-30 |
| Last Update Date | 2022-06-07 |