| NPI | 1467080721 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 2024-03606) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 1022079) |
| Enumeration Date | 2020-03-31 |
| Last Update Date | 2025-04-12 |