| NPI | 1982866356 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: OH 35123810) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4301092801) |
| Enumeration Date | 2008-06-27 |
| Last Update Date | 2017-10-05 |