| NPI | 1043574874 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MI 5101019855) |
| Additional Taxonomies | 208D00000X General Practice (Licence: MI 5101019855) |
| Enumeration Date | 2012-06-26 |
| Last Update Date | 2019-05-16 |