| NPI | 1386176964 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MI 4301509253) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 2025-02380) |
| Enumeration Date | 2017-04-01 |
| Last Update Date | 2025-10-28 |