| NPI | 1295943579 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NE CP1929) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CO 50144) |
| 207X00000X Orthopaedic Surgery (Licence: OH 35.095565) | |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2026-04-10 |