| NPI | 1174186969 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CO DR.0075691) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 1017916) |
| Enumeration Date | 2019-04-17 |
| Last Update Date | 2025-10-22 |