| NPI | 1093152340 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 63745) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WI 70002) |
| 207X00000X Orthopaedic Surgery (Licence: IL 125063117) | |
| Enumeration Date | 2013-05-28 |
| Last Update Date | 2018-11-16 |