| NPI | 1144458670 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: KS 04-38256) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: GA 070916) |
| Enumeration Date | 2009-06-23 |
| Last Update Date | 2016-11-15 |