| NPI | 1225482060 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 0101274402) | 
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MD D0094473) | 
| 207X00000X Orthopaedic Surgery (Licence: CO DR.0070386) | |
| 207X00000X Orthopaedic Surgery (Licence: NC 217892) | |
| Enumeration Date | 2016-04-18 | 
| Last Update Date | 2023-09-13 |