| NPI | 1639166143 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: KS 04-18898) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: KS 0418898) |
| Enumeration Date | 2005-09-29 |
| Last Update Date | 2024-02-02 |