| NPI | 1215258736 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: KS 04-41486) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2016016714) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: KS 04-41486) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: MO 2016016714) | |
| Enumeration Date | 2010-06-18 |
| Last Update Date | 2021-06-18 |