| NPI | 1114217320 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: KS 04-42091) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: GA 77991) |
| Enumeration Date | 2011-04-10 |
| Last Update Date | 2019-08-05 |