| NPI | 1942705322 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 100792) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: SC MD92222) |
| Enumeration Date | 2018-03-27 |
| Last Update Date | 2024-12-06 |