| NPI | 1992145353 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL OS17060) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 5315060107) |
| Enumeration Date | 2013-07-01 |
| Last Update Date | 2025-05-07 |