| NPI | 1053348755 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: ND LT 12503) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 36484) |
| 207XX0801X Orthopaedic Surgery Orthopaedic Trauma (Licence: CA G083802) | |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2021-07-27 |