| NPI | 1609365113 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AK 220249) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX 679722) |
| Enumeration Date | 2018-05-09 |
| Last Update Date | 2024-05-13 |