| NPI | 1659578060 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: KS 04-37583) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2020040718) |
| 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: KS 04-37583) | |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2024-07-18 |