| NPI | 1396067328 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: MO 2018011903) |
| Additional Taxonomies | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: MI 5101018944) |
| Enumeration Date | 2010-02-17 |
| Last Update Date | 2018-09-12 |