| NPI | 1760828263 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WI 70809-20) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4301114402) |
| 207X00000X Orthopaedic Surgery (Licence: KS 9408096) | |
| Enumeration Date | 2013-05-12 |
| Last Update Date | 2023-04-19 |