| NPI | 1356876924 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AK 197119) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NE 31411) |
| Enumeration Date | 2017-04-20 |
| Last Update Date | 2024-03-08 |