| NPI | 1558650176 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NE 27071) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: GU MC-323) |
| Enumeration Date | 2011-04-05 |
| Last Update Date | 2025-10-09 |