| NPI | 1578766291 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: ID O-1852) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA ff1546780) |
| 207X00000X Orthopaedic Surgery (Licence: CO DR48671) | |
| 207X00000X Orthopaedic Surgery (Licence: NV ff1012094) | |
| Enumeration Date | 2007-06-08 |
| Last Update Date | 2025-08-29 |