| NPI | 1487278297 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: IA 57036) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 30729) |
| 207X00000X Orthopaedic Surgery (Licence: MN 70230) | |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: GA 104474) | |
| Enumeration Date | 2020-06-08 |
| Last Update Date | 2026-09-24 |