| NPI | 1285080291 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MI 5101025058) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NH 22270) |
| 207X00000X Orthopaedic Surgery (Licence: MA 286583) | |
| 207X00000X Orthopaedic Surgery (Licence: MI 5101022256) | |
| Enumeration Date | 2016-05-09 |
| Last Update Date | 2022-10-20 |