| NPI | 1750792446 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MI 4301502027) |
| Additional Taxonomies | 208600000X Surgery (Licence: SC 36808) |
| Enumeration Date | 2014-05-15 |
| Last Update Date | 2023-02-02 |