| NPI | 1033564687 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: LA 339660) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AL MD.44785) |
| Enumeration Date | 2016-05-02 |
| Last Update Date | 2025-07-24 |