| NPI | 1265964670 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MO 2024017196) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TN 66959) |
| Enumeration Date | 2017-04-03 |
| Last Update Date | 2025-03-17 |