| NPI | 1699760215 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MI KR064676) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4301064676) |
| 207R00000X Internal Medicine (Licence: MI 4301064676) | |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2018-02-01 |