| NPI | 1548403231 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AK 102696) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WI 55868-20) |
| 207X00000X Orthopaedic Surgery (Licence: NV 17227) | |
| Enumeration Date | 2009-04-11 |
| Last Update Date | 2022-01-31 |