| NPI | 1275911620 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX S9280) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OK 31499) |
| Enumeration Date | 2015-05-18 |
| Last Update Date | 2021-12-27 |