| NPI | 1477177517 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME173663) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4351046914) |
| Enumeration Date | 2020-06-04 |
| Last Update Date | 2025-06-09 |