| NPI | 1760943765 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 105226) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MD D0100579) |
| Enumeration Date | 2019-03-31 |
| Last Update Date | 2026-08-20 |