| NPI | 1093709776 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX M8405) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: DE CI-0006680) |
| 207X00000X Orthopaedic Surgery (Licence: TX Temporary) | |
| Enumeration Date | 2005-09-08 |
| Last Update Date | 2014-10-14 |