| NPI | 1043353444 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery (Licence: MI 4301080456) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 230905) |
| 207X00000X Orthopaedic Surgery (Licence: MI 4301080456) | |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2014-07-30 |