| NPI | 1043299738 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 62397) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IA 28013) |
| 207X00000X Orthopaedic Surgery (Licence: SD 3947) | |
| Enumeration Date | 2006-01-11 |
| Last Update Date | 2022-07-21 |