| NPI | 1760726897 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: ID M-11820) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OR MD214337) |
| Enumeration Date | 2012-11-15 |
| Last Update Date | 2025-11-26 |