| NPI | 1174514962 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: DE C1-0023825) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: PA MD422655) |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2022-01-31 |