| NPI | 1659358091 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: SC 95473) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AL 27539) |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2025-09-25 |