| NPI | 1164758470 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: KS 0535312) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2009017068) |
| Enumeration Date | 2009-10-20 |
| Last Update Date | 2023-05-03 |