| NPI | 1437648961 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MO 2023012181) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4301505411) |
| Enumeration Date | 2018-05-10 |
| Last Update Date | 2023-07-25 |