| NPI | 1205064284 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 53245) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WI 67262-20) |
| 207X00000X Orthopaedic Surgery (Licence: WA MD60437017) | |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: WA MD60437017) | |
| Enumeration Date | 2009-06-29 |
| Last Update Date | 2020-08-21 |