| NPI | 1184784977 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MI 4301501997) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MD427458) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2020-07-08 |