| NPI | 1932548468 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 2019-02179) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VA 0101256934) |
| Enumeration Date | 2013-06-18 |
| Last Update Date | 2024-03-11 |