| NPI | 1568684975 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 062298) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KS 5956) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2014-01-20 |