| NPI | 1275760720 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 2024-03535) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: GA 74274) |
| Enumeration Date | 2009-06-11 |
| Last Update Date | 2025-02-12 |