| NPI | 1992364731 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: SC 91767) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4351044864) |
| Enumeration Date | 2019-06-06 |
| Last Update Date | 2024-08-02 |