| NPI | 1396139473 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MI 4301501492) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 2020-00132) |
| Enumeration Date | 2015-03-26 |
| Last Update Date | 2026-04-22 |