| NPI | 1891105425 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MI 4301116640) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 201071) |
| Enumeration Date | 2014-05-05 |
| Last Update Date | 2023-11-15 |