| NPI | 1093781916 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MO 2025054285) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KS 04-28636) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: KS 04-28636) | |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2026-01-28 |