| NPI | 1528471737 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: NC 2020-02810) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 5315066402) |
| Enumeration Date | 2014-06-05 |
| Last Update Date | 2023-08-31 |