| NPI | 1477713535 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX P6426) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KS 04-37030) |
| Enumeration Date | 2008-06-12 |
| Last Update Date | 2022-02-24 |