| NPI | 1093209090 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: AR E-18048) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: KS 94-11281) |
| Enumeration Date | 2018-06-22 |
| Last Update Date | 2024-07-23 |