| NPI | 1225189731 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MI 5101012508) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KS 05-38800) |
| 207X00000X Orthopaedic Surgery (Licence: TX J6340) | |
| Enumeration Date | 2007-01-13 |
| Last Update Date | 2022-09-13 |