| NPI | 1336991470 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WI 86653-20) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WI 101149-851) |
| Enumeration Date | 2024-04-02 |
| Last Update Date | 2026-01-18 |