| NPI | 1588975973 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 0102209713) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2016039951) |
| Enumeration Date | 2010-06-30 |
| Last Update Date | 2025-11-12 |