| NPI | 1417410432 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AZ 76365) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AZ R77245) |
| Enumeration Date | 2019-04-08 |
| Last Update Date | 2025-04-09 |