| NPI | 1235493099 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OR DO190678) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 5101020102) |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: MI 5101020102) | |
| Enumeration Date | 2012-06-26 |
| Last Update Date | 2019-07-29 |