| NPI | 1154396216 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NV DO1595) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AZ 4039) |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2021-12-06 |