| NPI | 1902260581 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: KS 04-46115) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 62511) |
| 207X00000X Orthopaedic Surgery (Licence: NC 2021-01620) | |
| Enumeration Date | 2016-04-08 |
| Last Update Date | 2022-07-29 |