| NPI | 1174505093 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TN 44061) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 270488) |
| Enumeration Date | 2005-11-16 |
| Last Update Date | 2026-01-14 |