| NPI | 1306225917 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MT 94667) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4301107490) |
| Enumeration Date | 2015-05-28 |
| Last Update Date | 2024-04-05 |