| NPI | 1659428530 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: IA 39003) |
| Additional Taxonomies | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: IA 39003) |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2025-03-28 |