| NPI | 1437710100 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MT MED-PHYS-LIC-159772) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NE 8598) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: KS 04-49649) | |
| Enumeration Date | 2019-06-24 |
| Last Update Date | 2025-07-30 |