| NPI | 1245313691 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: KS 0422901) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2010006907) |
| Enumeration Date | 2006-10-21 |
| Last Update Date | 2013-09-10 |