| NPI | 1548471048 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OK 27975) |
| Additional Taxonomies | 208D00000X General Practice (Licence: WV 22517) |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2023-04-11 |