| NPI | 1942883707 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MO 2026034869) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KS 05-53257) |
| Enumeration Date | 2021-04-29 |
| Last Update Date | 2026-07-22 |