| NPI | 1497381412 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 2025-00617) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: SC 94110) |
| Enumeration Date | 2020-03-21 |
| Last Update Date | 2025-07-29 |