| NPI | 1003880964 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 69632) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VA 0101233236) |
| 207X00000X Orthopaedic Surgery (Licence: MD D0078710) | |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2025-04-30 |