| NPI | 1982265179 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OK 46076) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4351045628) |
| Enumeration Date | 2019-06-27 |
| Last Update Date | 2025-11-25 |