| NPI | 1689202731 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: KS 05-51071) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 5101029067) |
| Enumeration Date | 2020-04-01 |
| Last Update Date | 2026-05-06 |