| NPI | 1285263533 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: ID 1681408) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AZ 011627) |
| Enumeration Date | 2020-04-07 |
| Last Update Date | 2026-07-28 |