| NPI | 1043539422 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 59358) |
| Additional Taxonomies | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: MN 59358) |
| Enumeration Date | 2010-05-24 |
| Last Update Date | 2019-12-19 |