| NPI | 1023464989 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NM DO2021-0044) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NM R-04-2016MNT) |
| Enumeration Date | 2016-05-10 |
| Last Update Date | 2023-08-03 |