| NPI | 1750898664 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: SC 97997) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: GA 11999) |
| Enumeration Date | 2018-01-02 |
| Last Update Date | 2026-08-28 |