| NPI | 1760681290 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 2017-00223) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 5101017267) |
| Enumeration Date | 2007-07-14 |
| Last Update Date | 2019-01-04 |