| NPI | 1487118634 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AZ 59590) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KS 04-41213) |
| Enumeration Date | 2019-01-22 |
| Last Update Date | 2020-12-28 |