| NPI | 1376587824 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NE 13053) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KS 04-20873) |
| 207X00000X Orthopaedic Surgery (Licence: OH 35.040175) | |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2008-10-10 |