| NPI | 1043874431 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A197573) |
| Additional Taxonomies | 208600000X Surgery (Licence: HI MDR-7719) |
| Enumeration Date | 2019-05-01 |
| Last Update Date | 2024-09-04 |