| NPI | 1770997314 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 97428) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NE 29204) |
| Enumeration Date | 2014-06-11 |
| Last Update Date | 2025-06-24 |