| NPI | 1851730501 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OH 34.013147) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 5101020657) |
| Enumeration Date | 2013-06-17 |
| Last Update Date | 2021-09-13 |