| NPI | 1568021095 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WI 83678-20) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KS 94-09851) |
| Enumeration Date | 2019-06-09 |
| Last Update Date | 2024-05-08 |