| NPI | 1003911603 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WI 53249-20) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 51884) |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2018-08-29 |