| NPI | 1306410444 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 74621) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 32495) |
| Enumeration Date | 2021-05-13 |
| Last Update Date | 2023-07-12 |