| NPI | 1548231384 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: MI 4301067755) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI HP067755) |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2017-02-22 |