| NPI | 1548792971 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 0101278706) |
| Additional Taxonomies | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: VA 0101278706) |
| Enumeration Date | 2017-04-03 |
| Last Update Date | 2023-05-18 |