| NPI | 1245437128 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 51024) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME184088) |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2026-08-31 |