| NPI | 1073559803 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TN 27287) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KY C5076) |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2026-03-18 |