| NPI | 1265429252 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 36918) |
| Additional Taxonomies | 174400000X Specialist (Licence: GA 36918) |
| Enumeration Date | 2005-10-04 |
| Last Update Date | 2025-12-04 |