| NPI | 1477530111 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery (Licence: TX V4656) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX V4656) |
| Enumeration Date | 2005-12-23 |
| Last Update Date | 2025-08-26 |