| NPI | 1144480534 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MI 5101017677) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 2013-01285) |
| Enumeration Date | 2008-06-10 |
| Last Update Date | 2015-06-15 |