| NPI | 1578818779 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OH 34.013311) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA OS017323) |
| Enumeration Date | 2012-07-13 |
| Last Update Date | 2025-12-17 |