| NPI | 1497963425 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MI 5101017179) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL OS11624) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2021-06-04 |