| NPI | 1396748505 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NE 16560) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KS 04-24466) |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2009-11-11 |