| NPI | 1669912028 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA OS023199) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: DE C2-0024299) |
| Enumeration Date | 2017-03-06 |
| Last Update Date | 2026-01-09 |