| NPI | 1295927846 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 50192) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 103313) |
| Enumeration Date | 2007-08-16 |
| Last Update Date | 2007-11-19 |