| NPI | 1760447379 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: LA 310836) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 51231) |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2025-05-05 |