| NPI | 1134606684 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 71921) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 31614) |
| Enumeration Date | 2018-07-26 |
| Last Update Date | 2022-08-16 |