| NPI | 1669681797 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OH 35132377) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4301085942) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2018-01-12 |