| NPI | 1689154320 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: SC 87731) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IN PENDING) |
| Enumeration Date | 2018-08-21 |
| Last Update Date | 2022-11-02 |