| NPI | 1538570411 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WI 73594) |
| Additional Taxonomies | 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery (Licence: CO 62396) |
| 207X00000X Orthopaedic Surgery (Licence: MN 67604) | |
| 207X00000X Orthopaedic Surgery (Licence: MI 4301105130) | |
| Enumeration Date | 2014-05-14 |
| Last Update Date | 2021-03-22 |