| NPI | 1538587282 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MO 2021015043) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KS 04-44506) |
| Enumeration Date | 2014-03-31 |
| Last Update Date | 2024-01-04 |