| NPI | 1063618833 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX P2237) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 5101017328) |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2024-05-07 |