| NPI | 1740523265 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OR MD193280) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NV 17641) |
| 207X00000X Orthopaedic Surgery (Licence: WA MD60956423) | |
| Enumeration Date | 2013-04-03 |
| Last Update Date | 2026-07-15 |