| NPI | 1548791106 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 0101281821) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 2023-00893) |
| Enumeration Date | 2017-03-24 |
| Last Update Date | 2024-07-31 |