| NPI | 1598746604 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: WI 61642-20) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: ID MC-2704) |
| Enumeration Date | 2005-11-07 |
| Last Update Date | 2025-10-15 |