| NPI | 1932195393 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 2022-01375) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4301061042) |
| Enumeration Date | 2005-09-21 |
| Last Update Date | 2022-08-24 |