| NPI | 1316994270 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WV 22700) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VA 0101229781) |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2026-08-04 |