| NPI | 1356755433 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MI 4301105463) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 65214) |
| Enumeration Date | 2014-06-17 |
| Last Update Date | 2023-04-21 |