| NPI | 1891289351 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: IA R-11344) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: GA 95646) |
| Enumeration Date | 2018-06-19 |
| Last Update Date | 2023-07-27 |