| NPI | 1609238302 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: KS 04-46647) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: MO 2022038657) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CO DR.0059317) | |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2022-09-30 |