| NPI | 1508354499 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AZ 73424) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 35.147721) |
| Enumeration Date | 2018-04-25 |
| Last Update Date | 2024-09-12 |