| NPI | 1508919622 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AL 1149) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA 20A9623) |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2026-06-16 |