| NPI | 1326401456 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: KS 04-46252) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CA A173009) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: MO 2019014833) | |
| Enumeration Date | 2016-04-05 |
| Last Update Date | 2022-09-30 |