| NPI | 1780812321 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: SC 31882) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX Q3980) |
| Enumeration Date | 2009-06-22 |
| Last Update Date | 2025-06-18 |