| NPI | 1922090794 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: KS 04-28403) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: MO 2004010787) |
| Enumeration Date | 2005-08-18 |
| Last Update Date | 2022-10-03 |