| NPI | 1770878142 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: KS 7607) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WI 6706) |
| Enumeration Date | 2011-06-14 |
| Last Update Date | 2017-09-13 |