| NPI | 1073042701 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: LA 338456) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AL MD.44067) |
| Enumeration Date | 2017-06-06 |
| Last Update Date | 2026-06-23 |