| NPI | 1053771204 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: MN 70990) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 70990) |
| Enumeration Date | 2016-03-01 |
| Last Update Date | 2024-08-22 |