| NPI | 1952925281 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX V8048) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX BP10072221) |
| Enumeration Date | 2020-06-02 |
| Last Update Date | 2025-07-24 |