| NPI | 1649531161 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 2023-00145) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4301100434) |
| Enumeration Date | 2012-05-31 |
| Last Update Date | 2023-02-15 |