| NPI | 1134494339 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TN 58893) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WI 73506) |
| Enumeration Date | 2012-03-20 |
| Last Update Date | 2026-02-04 |