| NPI | 1629572359 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 0101282727) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TN 67705) |
| 207X00000X Orthopaedic Surgery (Licence: IL 125.072495) | |
| Enumeration Date | 2018-03-19 |
| Last Update Date | 2024-07-28 |