| NPI | 1285892968 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: UT 8983499-1205) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NV 14663) |
| Enumeration Date | 2008-05-29 |
| Last Update Date | 2026-06-30 |