| NPI | 1740540707 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: ND 15178) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4301100674) |
| Enumeration Date | 2012-05-24 |
| Last Update Date | 2018-08-22 |