| NPI | 1386693158 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: SC 34030) |
| Additional Taxonomies | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: SC 34030) |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2025-10-02 |