| NPI | 1760517478 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OR 43700) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 5101015261) |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2009-06-26 |