| NPI | 1346620366 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WI 73377) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4301107906) |
| Enumeration Date | 2015-06-04 |
| Last Update Date | 2023-01-11 |