| NPI | 1609962778 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MO 2025027549) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI BB067457) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2025-08-05 |