| NPI | 1730708397 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: UT 14268486-1205) |
| Additional Taxonomies | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: MO 2025021828) |
| Enumeration Date | 2020-04-14 |
| Last Update Date | 2026-06-30 |