| NPI | 1073959680 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 63314) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IA MD-45969) |
| Enumeration Date | 2013-05-22 |
| Last Update Date | 2021-09-24 |