| NPI | 1124464227 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MI 4301117454) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 2018-000240) |
| Enumeration Date | 2013-05-15 |
| Last Update Date | 2025-03-13 |