| NPI | 1790070035 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: DE C2-0000458) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA OT014316) |
| Enumeration Date | 2011-06-15 |
| Last Update Date | 2022-02-15 |