| NPI | 1730201112 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: SC 1429) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 5101016197) |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2022-01-26 |