| NPI | 1932103983 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL OS13537) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI TP013084) |
| Enumeration Date | 2005-06-08 |
| Last Update Date | 2023-07-18 |