| NPI | 1164489761 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: SC 33999) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 35082979S) |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2025-04-03 |