| NPI | 1811333008 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MI 4301117275) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MT203824) |
| Enumeration Date | 2013-05-15 |
| Last Update Date | 2019-08-02 |