| NPI | 1649775487 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CO DR.0072771) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 73609) |
| Enumeration Date | 2018-03-26 |
| Last Update Date | 2025-06-19 |