| NPI | 1154777050 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX V2090) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 286461) |
| Enumeration Date | 2016-05-10 |
| Last Update Date | 2024-08-06 |