| NPI | 1184329583 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WI 84960-20) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WI 100482-851) |
| Enumeration Date | 2023-04-04 |
| Last Update Date | 2025-05-27 |