| NPI | 1790975787 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MO 2008018560) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TN 3501) |
| Enumeration Date | 2007-07-26 |
| Last Update Date | 2024-01-16 |