| NPI | 1124258223 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 50713) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WI 55776) |
| Enumeration Date | 2009-07-23 |
| Last Update Date | 2019-03-12 |