| NPI | 1497370050 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: MI 5101029355) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 5151014173) |
| Enumeration Date | 2020-06-10 |
| Last Update Date | 2026-08-04 |