| NPI | 1174598163 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 38198) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: ME MD22995) |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2023-06-30 |