| NPI | 1184329583 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WI 84960-20) | 
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WI 100482-851) | 
| Enumeration Date | 2023-04-04 | 
| Last Update Date | 2025-05-27 |