| NPI | 1912293952 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: MO 2016008742) | 
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2016008742) | 
| Enumeration Date | 2011-06-28 | 
| Last Update Date | 2024-06-26 |