| NPI | 1669402137 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: KS 04-31227) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VT 0420011001) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2021-06-11 |