| NPI | 1023671146 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: CO DR00772896) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CO DR.0072896) |
| Enumeration Date | 2019-04-15 |
| Last Update Date | 2025-06-23 |