| NPI | 1639531346 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: KY 55718) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TN 62923) |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2024-10-29 |