| NPI | 1184189821 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NE 3016) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL OS17355) |
| Enumeration Date | 2019-02-06 |
| Last Update Date | 2025-07-17 |