| NPI | 1467652875 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AK 191513)  | 
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 5101015602)  | 
| 207X00000X Orthopaedic Surgery (Licence: AZ 4782)  | |
| Enumeration Date | 2007-07-23 | 
| Last Update Date | 2023-11-27 |