| NPI | 1376715144 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OH 34.011457) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA OS015259) |
| Enumeration Date | 2008-04-01 |
| Last Update Date | 2021-09-01 |