| NPI | 1700105988 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OR MD179256) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4301096562) |
| Enumeration Date | 2010-05-27 |
| Last Update Date | 2020-11-09 |