| NPI | 1558586073 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MI 4301084641) | 
| Additional Taxonomies | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: TN 45006) | 
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: TN MD45006) | |
| Enumeration Date | 2007-04-17 | 
| Last Update Date | 2013-04-25 |