| NPI | 1376072819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WI 84137-20) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IA R-10836) |
| Enumeration Date | 2017-06-08 |
| Last Update Date | 2024-12-20 |