| NPI | 1932515392 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PR 21543) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 278143) |
| Enumeration Date | 2014-07-07 |
| Last Update Date | 2024-08-23 |