| NPI | 1356557623 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MI 4301086275) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME106819) |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2020-10-23 |