| NPI | 1891789327 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 0101276691) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: GA 036935) |
| 207X00000X Orthopaedic Surgery (Licence: TX H3660) | |
| Enumeration Date | 2005-09-12 |
| Last Update Date | 2025-08-29 |