| NPI | 1265414890 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery (Licence: KS 0427888) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KS 04-27888) |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2011-05-10 |