| NPI | 1033558259 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MO 2019016580) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NE 1205) |
| Enumeration Date | 2013-06-20 |
| Last Update Date | 2024-07-11 |