| NPI | 1134682966 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 82207) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VT 060.0005238) |
| Enumeration Date | 2019-04-09 |
| Last Update Date | 2026-06-02 |