| NPI | 1023122991 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AK 3104) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AK AK3104) |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2016-03-22 |