| NPI | 1124221262 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: OK 29032) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: HI 14311) |
| Enumeration Date | 2007-06-07 |
| Last Update Date | 2017-02-21 |