| NPI | 1346551439 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: KY TP500) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KS 94-07385) |
| Enumeration Date | 2010-06-23 |
| Last Update Date | 2015-06-25 |