| NPI | 1750511416 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 0101258149) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MT195974) |
| Enumeration Date | 2009-07-15 |
| Last Update Date | 2023-12-29 |