| NPI | 1134236284 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 44874) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MD D60737) |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2007-08-27 |