NPI | 1104679539 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 80298) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 34420) |
Enumeration Date | 2024-04-08 |
Last Update Date | 2025-08-27 |