| NPI | 1033598321 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 60951) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WI 75628) |
| Enumeration Date | 2015-05-20 |
| Last Update Date | 2021-09-15 |