| NPI | 1053537779 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AZ 44644) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KS 6620) |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2022-04-19 |