| NPI | 1861953994 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WI 76162-20) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MS 33304) |
| Enumeration Date | 2019-03-29 |
| Last Update Date | 2025-09-05 |