| NPI | 1609480656 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MI 5151017129) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MI 5302412674) |
| Enumeration Date | 2020-09-06 |
| Last Update Date | 2025-05-28 |