| NPI | 1861920423 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 2022-01592) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MS T-3369) |
| Enumeration Date | 2017-05-26 |
| Last Update Date | 2022-06-21 |