| NPI | 1972032753 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MO 2024000213) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A184896) |
| 207X00000X Orthopaedic Surgery (Licence: RI MD18287) | |
| Enumeration Date | 2017-06-06 |
| Last Update Date | 2024-10-24 |