| NPI | 1306139282 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: KS 04-40099) |
| Additional Taxonomies | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: MO 2017018231) |
| 207X00000X Orthopaedic Surgery (Licence: KS 04-40099) | |
| 207X00000X Orthopaedic Surgery (Licence: MO 2017018231) | |
| Enumeration Date | 2011-05-25 |
| Last Update Date | 2025-11-07 |