| NPI | 1114542776 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MI 5101028103) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 5151014394) |
| Enumeration Date | 2020-06-10 |
| Last Update Date | 2026-09-23 |