| NPI | 1811929557 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AL DO.1220) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MS 19174) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2024-05-07 |