| NPI | 1801982665 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MI 4301091329) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WV 12237) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2010-12-17 |