| NPI | 1558654392 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: KS 05-38785) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KS 05-38785) |
| Enumeration Date | 2011-05-26 |
| Last Update Date | 2022-07-21 |