| NPI | 1902302607 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MS 31529) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: UT 11412496-1205) |
| Enumeration Date | 2018-04-02 |
| Last Update Date | 2023-11-10 |