| NPI | 1740270990 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 2024-03085) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 35-04-7879) |
| Enumeration Date | 2005-10-27 |
| Last Update Date | 2025-05-15 |