| NPI | 1043535552 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: MI 4301109159) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4301109159) |
| Enumeration Date | 2010-03-29 |
| Last Update Date | 2026-04-27 |