| NPI | 1851740153 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MS 28442) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX BP10056537) |
| Enumeration Date | 2016-06-07 |
| Last Update Date | 2022-08-11 |