| NPI | 1568023133 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 104482) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MS 32652) |
| Enumeration Date | 2019-06-25 |
| Last Update Date | 2025-07-25 |