| NPI | 1841878378 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 111065) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 31605) |
| 207X00000X Orthopaedic Surgery (Licence: MN 71905) | |
| Enumeration Date | 2021-03-29 |
| Last Update Date | 2026-05-20 |