| NPI | 1023515467 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 0101279034) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IA R-11148) |
| Enumeration Date | 2018-04-11 |
| Last Update Date | 2023-07-21 |