| NPI | 1891019972 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CO DR.0062917) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NE 26530) |
| Enumeration Date | 2010-03-18 |
| Last Update Date | 2023-07-28 |