| NPI | 1003297904 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: TX T0312) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KS 94-08721) |
| Enumeration Date | 2015-06-16 |
| Last Update Date | 2024-07-23 |