| NPI | 1740841659 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX T7940) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX BP10068221) |
| Enumeration Date | 2019-06-23 |
| Last Update Date | 2025-08-08 |