| NPI | 1093342883 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TN 6711) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VA 0102209892) |
| Enumeration Date | 2020-03-24 |
| Last Update Date | 2026-07-27 |