| NPI | 1508022609 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MI 4301107507) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2008015994) |
| Enumeration Date | 2008-07-29 |
| Last Update Date | 2016-10-14 |