| NPI | 1609370824 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MO 2023010877) |
| Additional Taxonomies | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: NY 308468) |
| Enumeration Date | 2018-03-21 |
| Last Update Date | 2024-09-02 |