| NPI | 1295175651 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AK 139353) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 5101020630) |
| Enumeration Date | 2013-07-01 |
| Last Update Date | 2023-09-25 |