| NPI | 1518195619 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: SD 11279) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NE 31149) |
| 207X00000X Orthopaedic Surgery (Licence: KS 94-07232) | |
| 207X00000X Orthopaedic Surgery (Licence: IA MD-42778) | |
| Enumeration Date | 2009-06-26 |
| Last Update Date | 2025-12-10 |