| NPI | 1770621393 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MO 2025001002) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AZ 80271) |
| Enumeration Date | 2007-02-03 |
| Last Update Date | 2026-08-16 |