| NPI | 1134495666 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OK 39030) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NE 27449) |
| 207X00000X Orthopaedic Surgery (Licence: FL ME133594) | |
| Enumeration Date | 2012-03-29 |
| Last Update Date | 2022-05-11 |