| NPI | 1083297519 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 77505) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 33316) |
| Enumeration Date | 2021-05-03 |
| Last Update Date | 2024-08-16 |