| NPI | 1982269148 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: SC 95351) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VA 0101281611) |
| Enumeration Date | 2019-05-03 |
| Last Update Date | 2025-11-24 |