| NPI | 1396794152 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WI 48543) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WY 8254A) |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2026-02-16 |