| NPI | 1548258031 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AZ 50548) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4301059822) |
| Enumeration Date | 2005-10-10 |
| Last Update Date | 2020-04-03 |