| NPI | 1629580436 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AZ 56432) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VT 042.0013905) |
| Enumeration Date | 2017-11-02 |
| Last Update Date | 2023-08-11 |