| NPI | 1659306975 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: UT 5820907-8905) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AZ 35581) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2025-06-03 |