| NPI | 1396001079 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: ND 15169) |
| Additional Taxonomies | 207XX0801X Orthopaedic Surgery Orthopaedic Trauma (Licence: AZ 53215) |
| Enumeration Date | 2012-04-06 |
| Last Update Date | 2025-04-29 |