| NPI | 1154684918 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 102448) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CO DR.0059865) |
| Enumeration Date | 2012-06-18 |
| Last Update Date | 2025-02-11 |