| NPI | 1538457445 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WI 65994) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 5101019152) |
| Enumeration Date | 2011-07-12 |
| Last Update Date | 2024-09-17 |