| NPI | 1487159620 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 100920) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AZ 69163) |
| Enumeration Date | 2018-03-29 |
| Last Update Date | 2025-02-27 |