| NPI | 1093710089 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: 19-516) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MS 14510) |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2026-01-14 |