| NPI | 1598105140 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AZ 007594) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: SC DO82118) |
| 207X00000X Orthopaedic Surgery (Licence: MI 5101020756) | |
| 207X00000X Orthopaedic Surgery (Licence: GA 82997) | |
| Enumeration Date | 2013-06-27 |
| Last Update Date | 2026-02-24 |