| NPI | 1437123320 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: SD 7258) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 45820) |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2026-04-21 |