| NPI | 1255642344 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WI 86408-020) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 262109) |
| Enumeration Date | 2010-06-23 |
| Last Update Date | 2026-01-16 |