| NPI | 1710030044 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AK 240356) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: AK 240356) |
| 207X00000X Orthopaedic Surgery (Licence: GA 58800) | |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2026-02-17 |