| NPI | 1083891675 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: IA DO-4433) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 5101016427) |
| Enumeration Date | 2008-01-25 |
| Last Update Date | 2015-02-05 |