| NPI | 1780244954 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OK 45496) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KS 94-09932) |
| 207X00000X Orthopaedic Surgery (Licence: FL ME167598) | |
| Enumeration Date | 2019-06-19 |
| Last Update Date | 2025-08-04 |