| NPI | 1982230991 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MS 37268) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 1022022) |
| Enumeration Date | 2020-03-21 |
| Last Update Date | 2026-08-06 |