| NPI | 1053848978 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A157988) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MD D0094843) |
| 207X00000X Orthopaedic Surgery (Licence: VA 0101275136) | |
| Enumeration Date | 2017-05-23 |
| Last Update Date | 2023-08-10 |