| NPI | 1518089465 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 058804) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 2007-01256) |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2025-08-18 |