| NPI | 1851880389 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MA 1013033) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4301114531) |
| Enumeration Date | 2018-05-10 |
| Last Update Date | 2023-06-01 |