| NPI | 1235716184 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 71974) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 31993) |
| Enumeration Date | 2021-03-26 |
| Last Update Date | 2022-08-11 |