| NPI | 1699770941 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 69267) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KS 0524850) |
| 207X00000X Orthopaedic Surgery (Licence: MO 102737) | |
| 207X00000X Orthopaedic Surgery (Licence: OK 4865) | |
| Enumeration Date | 2005-06-14 |
| Last Update Date | 2024-06-21 |