| NPI | 1215506464 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AL MD.53533) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: SC 86305) |
| Enumeration Date | 2021-06-22 |
| Last Update Date | 2026-06-18 |