| NPI | 1649847914 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MI 4351047505) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: GA 111715) |
| Enumeration Date | 2021-06-07 |
| Last Update Date | 2026-07-13 |