| NPI | 1689161218 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NV 25086) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CO DR.00755579) |
| Enumeration Date | 2018-04-19 |
| Last Update Date | 2025-09-03 |