| NPI | 1104169416 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NH 17877) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 2018-00154) |
| Enumeration Date | 2013-04-04 |
| Last Update Date | 2023-11-20 |