| NPI | 1063507424 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 013754) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 13754) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2025-12-04 |