| NPI | 1366693335 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL OS21677) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 2020-03034) |
| Enumeration Date | 2008-10-08 |
| Last Update Date | 2025-08-10 |