| NPI | 1063646305 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WI 63870-021) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 5101018111) |
| Enumeration Date | 2009-05-14 |
| Last Update Date | 2023-12-08 |