| NPI | 1861440133 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CO 44575) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 43692) |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2026-02-11 |