| NPI | 1629579917 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL 145009) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WV 35479) |
| Enumeration Date | 2018-02-22 |
| Last Update Date | 2026-02-09 |