| NPI | 1417731043 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OK 44823) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: LA 337223) |
| Enumeration Date | 2023-08-23 |
| Last Update Date | 2025-08-12 |