| NPI | 1053841916 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 0101278679) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: SC LL41020) |
| Enumeration Date | 2017-06-14 |
| Last Update Date | 2023-10-16 |