| NPI | 1770089005 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: UT 13901333-1205) |
| Additional Taxonomies | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: MO 2023006696) |
| Enumeration Date | 2018-04-04 |
| Last Update Date | 2024-08-28 |