| NPI | 1235529702 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WI 85791-20) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 35.149240) |
| 207X00000X Orthopaedic Surgery (Licence: NE 29493) | |
| 207X00000X Orthopaedic Surgery (Licence: KS 04-43200) | |
| 208D00000X General Practice (Licence: NE 29493) | |
| Enumeration Date | 2015-02-04 |
| Last Update Date | 2025-08-20 |