| NPI | 1619960036 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: KS 04-21698) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KS 0421698) |
| Enumeration Date | 2005-08-31 |
| Last Update Date | 2019-05-30 |