| NPI | 1215005004 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: DE C1-0009406) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MD018066E) |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2012-10-12 |