| NPI | 1235355587 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX N9540) |
| Additional Taxonomies | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: TX N9540) |
| 207X00000X Orthopaedic Surgery (Licence: KS 6412) | |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2025-11-06 |