| NPI | 1821162462 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 67752) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AL MD.31700) |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2025-08-06 |