| NPI | 1750838157 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: FL ME162210) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4301114915) |
| Enumeration Date | 2016-09-02 |
| Last Update Date | 2023-08-09 |