| NPI | 1851952311 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OH 35.150126) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4351045041) |
| Enumeration Date | 2019-06-25 |
| Last Update Date | 2024-06-27 |