| NPI | 1295262194 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 0101278242) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 2022-01669) |
| Enumeration Date | 2017-05-23 |
| Last Update Date | 2023-10-16 |