| NPI | 1760400055 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 2005-00864) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: SC 23728) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2025-03-19 |