| NPI | 1609372499 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX V2329) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2023009376) |
| Enumeration Date | 2018-04-02 |
| Last Update Date | 2024-09-27 |