| NPI | 1417155797 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: IA DO-05611) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NE 1093) |
| 207X00000X Orthopaedic Surgery (Licence: MI 5101017380) | |
| Enumeration Date | 2007-07-06 |
| Last Update Date | 2023-12-13 |