| NPI | 1093591828 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: IA T-1193) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: GA 99836) |
| Enumeration Date | 2023-09-07 |
| Last Update Date | 2024-05-15 |