| NPI | 1225188873 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MO 2011013949) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KS 04-32340) |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2022-04-22 |