| NPI | 1548674625 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MI 4301104747) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME139300) |
| Enumeration Date | 2014-06-17 |
| Last Update Date | 2020-09-03 |