| NPI | 1215342746 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 67395) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NE 7288) |
| Enumeration Date | 2014-06-23 |
| Last Update Date | 2020-08-20 |