| NPI | 1508178799 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: KY 48167) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4301096967) |
| Enumeration Date | 2010-07-05 |
| Last Update Date | 2016-07-22 |