| NPI | 1598150492 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AZ 007452) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL UO3595) |
| 207X00000X Orthopaedic Surgery (Licence: KS 05-42364) | |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2025-04-18 |