| NPI | 1922194257 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: SC 81642) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 35488) |
| 207X00000X Orthopaedic Surgery (Licence: OR MD221964) | |
| 207X00000X Orthopaedic Surgery (Licence: VA 0101225946) | |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2026-01-02 |