| NPI | 1205986825 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: TX N5187) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KS 94-06192) |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2021-03-23 |