| NPI | 1447372230 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX M9069) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4301089527) |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2018-03-17 |