| NPI | 1134179419 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 26543) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WI 33472) |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2024-04-08 |