| NPI | 1962922674 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: IA MD50958) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4301112473) |
| 207X00000X Orthopaedic Surgery (Licence: IL 036163772) | |
| 207X00000X Orthopaedic Surgery (Licence: TN 64719) | |
| Enumeration Date | 2017-06-23 |
| Last Update Date | 2023-08-21 |