| NPI | 1689833774 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WI 62673) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4301092223) |
| Enumeration Date | 2008-06-04 |
| Last Update Date | 2023-11-30 |