| NPI | 1366895872 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OK 7190) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2016022465) |
| Enumeration Date | 2016-07-20 |
| Last Update Date | 2023-07-07 |