| NPI | 1023094448 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: SC 93938) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 2024-00277) |
| Enumeration Date | 2005-12-17 |
| Last Update Date | 2025-08-26 |