| NPI | 1073799433 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: SC 36194) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: GA 113522) |
| Enumeration Date | 2008-01-16 |
| Last Update Date | 2026-08-06 |