| NPI | 1407210081 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CO DR.0071295) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NM DO2021-0037) |
| Enumeration Date | 2016-04-08 |
| Last Update Date | 2026-07-06 |