| NPI | 1295878890 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: MT MED-PHYS-LIC-10146) |
| Additional Taxonomies | 174400000X Specialist (Licence: MT 10146) |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2025-11-18 |