| NPI | 1396009866 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: KS 0536582) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2012020181) |
| Enumeration Date | 2012-06-29 |
| Last Update Date | 2017-11-08 |