| NPI | 1598768830 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AZ 75667) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 119582) |
| 207X00000X Orthopaedic Surgery (Licence: SC 51607) | |
| Enumeration Date | 2005-05-31 |
| Last Update Date | 2025-04-14 |