| NPI | 1811427263 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 2023-01930) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 28435) |
| 207X00000X Orthopaedic Surgery (Licence: MN 64196) | |
| Enumeration Date | 2017-06-19 |
| Last Update Date | 2023-08-03 |