| NPI | 1033596069 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MI 5101026388) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 5101021549) |
| Enumeration Date | 2015-04-28 |
| Last Update Date | 2026-07-20 |