| NPI | 1023009370 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 62746) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NE 26452) |
| 207X00000X Orthopaedic Surgery (Licence: CA A84928) | |
| Enumeration Date | 2005-11-03 |
| Last Update Date | 2020-09-28 |