| NPI | 1821534116 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: MS 28907) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL UO4865) |
| Enumeration Date | 2017-01-11 |
| Last Update Date | 2021-08-07 |