| NPI | 1659892859 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MO 2017018448) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VA 0102207105) |
| Enumeration Date | 2017-06-28 |
| Last Update Date | 2023-08-22 |