| NPI | 1417536996 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CO DR.76803) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC RTL21-0169) |
| Enumeration Date | 2021-04-03 |
| Last Update Date | 2026-08-24 |