| NPI | 1639898620 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AZ 66968) |
| Additional Taxonomies | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: AZ 66968) |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: AZ 66968) | |
| Enumeration Date | 2022-08-24 |
| Last Update Date | 2026-08-03 |