| NPI | 1619468758 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CO 0070555) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: GA 009937) |
| Enumeration Date | 2018-05-24 |
| Last Update Date | 2023-06-06 |