| NPI | 1629573787 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AR e-18035) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WI 82327) |
| 207X00000X Orthopaedic Surgery (Licence: MN 29191) | |
| 207X00000X Orthopaedic Surgery (Licence: MN 65900) | |
| Enumeration Date | 2018-03-29 |
| Last Update Date | 2024-09-09 |