| NPI | 1073703187 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MO 2025004183) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 5101017371) |
| Enumeration Date | 2007-07-26 |
| Last Update Date | 2025-03-24 |