| NPI | 1063455673 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OK 26943) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WI 47872) |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2011-04-20 |