| NPI | 1922664069 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TN 70627) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 279565) |
| Enumeration Date | 2019-05-14 |
| Last Update Date | 2024-08-14 |