| NPI | 1750802807 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AZ 009627) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2017019588) |
| Enumeration Date | 2017-06-29 |
| Last Update Date | 2026-08-06 |