| NPI | 1942628268 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MI 4301501801) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 260703) |
| Enumeration Date | 2014-04-03 |
| Last Update Date | 2020-09-11 |