| NPI | 1518452408 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MA 1013375) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MT216802) |
| Enumeration Date | 2018-06-25 |
| Last Update Date | 2023-06-29 |