| NPI | 1871769208 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MI 4301107040) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MT195499) |
| Enumeration Date | 2008-05-06 |
| Last Update Date | 2020-10-22 |