| NPI | 1265406250 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MO R4956) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KS 05-45804) |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2026-04-02 |