| NPI | 1659877736 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: SD 15341) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 29142) |
| 207X00000X Orthopaedic Surgery (Licence: MN 65835) | |
| Enumeration Date | 2018-04-05 |
| Last Update Date | 2024-05-06 |