| NPI | 1518452473 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL 161869) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: SC LL52846) |
| Enumeration Date | 2018-06-24 |
| Last Update Date | 2023-09-10 |