| NPI | 1477764371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TN 47084) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VA 0101249306) |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2025-10-09 |