| NPI | 1528472982 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: FL OS22415) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VA 0102204395) |
| Enumeration Date | 2014-06-13 |
| Last Update Date | 2025-06-29 |