| NPI | 1639137276 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MO R5B82) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KS 04-25109) |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2011-03-09 |