| NPI | 1225558737 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MA 1014210) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MT213898) |
| Enumeration Date | 2017-06-26 |
| Last Update Date | 2024-01-12 |