| NPI | 1740230168 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: FL ME128677) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME128677) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: KS 0427501) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: MO 2005028565) | |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2021-03-25 |