| NPI | 1366937138 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MO 2018020296) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: GA 95437) |
| Enumeration Date | 2018-06-25 |
| Last Update Date | 2025-10-28 |