| NPI | 1639600174 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: ID M-17190) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AL MD.44439) |
| Enumeration Date | 2017-03-26 |
| Last Update Date | 2023-12-05 |