| NPI | 1568637395 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MO 2013002819) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KS 05-33327) |
| Enumeration Date | 2008-04-23 |
| Last Update Date | 2014-10-08 |