| NPI | 1063822377 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MI 4301105375) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2019009468) |
| Enumeration Date | 2014-05-08 |
| Last Update Date | 2020-08-07 |