| NPI | 1659585073 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AZ 44813) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4301080457) |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2019-07-26 |