| NPI | 1255321063 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OK 03659) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AZ 5350) |
| 207X00000X Orthopaedic Surgery (Licence: NM A-1339-05) | |
| 207X00000X Orthopaedic Surgery (Licence: MO 2003020127) | |
| Enumeration Date | 2005-10-24 |
| Last Update Date | 2016-03-02 |