| NPI | 1720206105 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: KS 0533071) |
| Additional Taxonomies | 207XP3100X Orthopaedic Surgery Pediatric Orthopaedic Surgery (Licence: MO 2007008574) |
| 207XX0801X Orthopaedic Surgery Orthopaedic Trauma (Licence: KS 0533071) | |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2017-04-05 |