| NPI | 1912565763 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: SC LL82680) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL 166939) |
| Enumeration Date | 2019-06-05 |
| Last Update Date | 2024-06-11 |