| NPI | 1487657409 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: KS 04-16839) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO R2A47) |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2013-01-07 |