| NPI | 1043658974 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CO DR.0063019) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2013018135) |
| Enumeration Date | 2013-06-13 |
| Last Update Date | 2023-03-02 |