| NPI | 1467652875 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AK 191513) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AZ 4782) |
| 207X00000X Orthopaedic Surgery (Licence: MI 5101015602) | |
| Enumeration Date | 2007-07-23 |
| Last Update Date | 2026-02-25 |