| NPI | 1528050390 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: KS 04-17541) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO R5489) |
| Enumeration Date | 2005-08-18 |
| Last Update Date | 2008-02-06 |