| NPI | 1922254028 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MI 4301095362) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 35.123293) |
| Enumeration Date | 2008-08-08 |
| Last Update Date | 2015-10-22 |