| NPI | 1144660986 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: SC 51251) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI L2509145) |
| Enumeration Date | 2013-06-25 |
| Last Update Date | 2022-01-28 |