| NPI | 1538689807 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MA 291379) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: SC LL41064) |
| Enumeration Date | 2017-06-27 |
| Last Update Date | 2026-02-12 |