| NPI | 1558652727 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MI 4301111317) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX Q8697) |
| Enumeration Date | 2011-04-22 |
| Last Update Date | 2025-02-10 |