| NPI | 1285058545 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 64238) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 28376) |
| Enumeration Date | 2014-02-06 |
| Last Update Date | 2025-04-23 |