| NPI | 1518311414 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 94486) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NE 30755) |
| Enumeration Date | 2016-04-17 |
| Last Update Date | 2024-03-26 |