| NPI | 1316158066 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: LA MD202737) | 
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: LA MD202737) | 
| Enumeration Date | 2007-05-24 | 
| Last Update Date | 2025-07-22 |