| NPI | 1194921585 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 54983) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NM RS20070358) |
| Enumeration Date | 2007-06-22 |
| Last Update Date | 2017-01-31 |