| NPI | 1033560503 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL OS19158) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 5101022802) |
| 207X00000X Orthopaedic Surgery (Licence: VA 0102206623) | |
| Enumeration Date | 2016-06-27 |
| Last Update Date | 2023-01-26 |