| NPI | 1063436285 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 0413725) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KS 0413725) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2011-09-26 |