| NPI | 1396185039 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: SC 82107) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 5101020521) |
| 207X00000X Orthopaedic Surgery (Licence: AZ 007472) | |
| Enumeration Date | 2013-06-26 |
| Last Update Date | 2021-02-22 |