| NPI | 1891364881 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MI 4301511482) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4351048800) |
| Enumeration Date | 2021-06-23 |
| Last Update Date | 2024-05-10 |