| NPI | 1629073903 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: KS 0520529) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO R8F33) |
| 207X00000X Orthopaedic Surgery (Licence: OK 2330) | |
| Enumeration Date | 2005-06-14 |
| Last Update Date | 2011-12-30 |