| NPI | 1770076473 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NE 36186) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KS 94-09572) |
| 207X00000X Orthopaedic Surgery (Licence: MN 73445) | |
| Enumeration Date | 2018-06-07 |
| Last Update Date | 2024-08-27 |