| NPI | 1235798083 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 75996) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4351044815) |
| Enumeration Date | 2019-06-06 |
| Last Update Date | 2024-08-23 |