| NPI | 1871053835 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: TX W4045) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 35.151351) |
| Enumeration Date | 2019-03-24 |
| Last Update Date | 2026-03-02 |