| NPI | 1891756011 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX M9369) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AZ 010823) |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2024-03-13 |