| NPI | 1144410952 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL OS13775) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NE 539) |
| 207X00000X Orthopaedic Surgery (Licence: VA 0102202797) | |
| Enumeration Date | 2007-07-27 |
| Last Update Date | 2026-03-03 |