| NPI | 1285837641 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WI 62077-21) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 5101015310) |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2020-12-18 |