| NPI | 1598299224 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 94702) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AL MD.38001) |
| Enumeration Date | 2017-04-19 |
| Last Update Date | 2023-08-01 |