| NPI | 1578791240 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MI 4301095012) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 35129521) |
| Enumeration Date | 2009-07-01 |
| Last Update Date | 2023-11-03 |