| NPI | 1720399819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: KS 04-38692) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KS 94-07445) |
| Enumeration Date | 2010-06-23 |
| Last Update Date | 2020-11-23 |