| NPI | 1114905932 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: UT 55861821205) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NV 10925) |
| Enumeration Date | 2006-01-03 |
| Last Update Date | 2025-03-27 |