| NPI | 1225419617 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: MO 2021033713) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2021033713) |
| Enumeration Date | 2015-06-11 |
| Last Update Date | 2025-04-15 |