| NPI | 1255562104 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AK 7493) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 20288) |
| Enumeration Date | 2009-07-27 |
| Last Update Date | 2017-01-18 |