| NPI | 1053357400 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OK 1842) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KS 05-23238) |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2018-02-09 |