| NPI | 1730543307 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OK 35078) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MD474242) |
| Enumeration Date | 2016-04-11 |
| Last Update Date | 2024-11-20 |