| NPI | 1225272396 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 0101258157) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2014004824) |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: VA 0101258157) | |
| Enumeration Date | 2009-04-20 |
| Last Update Date | 2026-03-12 |