| NPI | 1164818183 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: VA 0101272877) |
| Additional Taxonomies | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: CO DR.0063619) |
| Enumeration Date | 2015-04-07 |
| Last Update Date | 2026-09-29 |