| NPI | 1497318125 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA OS023487) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 5151013426) |
| Enumeration Date | 2019-04-18 |
| Last Update Date | 2024-06-24 |