| NPI | 1497497242 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: MI 5101028978) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207X00000X Orthopaedic Surgery (Licence: MI 5101028978) | |
| Enumeration Date | 2022-04-12 |
| Last Update Date | 2025-10-15 |