| NPI | 1164876413 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AZ 79236) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MD UMPs) |
| Enumeration Date | 2016-04-22 |
| Last Update Date | 2026-05-06 |