| NPI | 1396896577 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MT 10135) |
| Additional Taxonomies | 174400000X Specialist (Licence: MT 10135) |
| Enumeration Date | 2007-01-15 |
| Last Update Date | 2023-11-27 |