| NPI | 1114280898 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MI 4301100731) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 61606) |
| Enumeration Date | 2012-06-19 |
| Last Update Date | 2025-06-03 |