| NPI | 1912520651 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MI 5151014184) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5151014184) |
| Enumeration Date | 2020-05-27 |
| Last Update Date | 2023-01-07 |