| NPI | 1063835452 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 98462) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AL DO.1644) |
| Enumeration Date | 2014-01-21 |
| Last Update Date | 2024-01-25 |