| NPI | 1578901484 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME140023) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4301103375) |
| 207X00000X Orthopaedic Surgery (Licence: IN 01080568A) | |
| Enumeration Date | 2013-06-13 |
| Last Update Date | 2020-03-08 |