| NPI | 1295110922 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 68544) |
| Additional Taxonomies | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: OR MD181878) |
| 207X00000X Orthopaedic Surgery (Licence: CA 137749) | |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: MN 68544) | |
| Enumeration Date | 2015-07-23 |
| Last Update Date | 2022-07-21 |