| NPI | 1366891657 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MO 2021007456) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX BP10056536) |
| Enumeration Date | 2016-06-07 |
| Last Update Date | 2022-09-15 |