| NPI | 1467520478 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CO DR-46388) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AZ 55151) |
| 207X00000X Orthopaedic Surgery (Licence: FL None resident) | |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2025-10-17 |