| NPI | 1881905511 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OK 6499) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KY 04093) |
| Enumeration Date | 2010-06-28 |
| Last Update Date | 2023-10-03 |