| NPI | 1043574650 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MO 2012017895) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KS 05-50963) |
| Enumeration Date | 2012-06-28 |
| Last Update Date | 2025-06-06 |