| NPI | 1164917779 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WI 81454-21) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: ID O-1746) |
| Enumeration Date | 2018-06-26 |
| Last Update Date | 2025-01-14 |