| NPI | 1316280563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 63498) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WI 69980) |
| Enumeration Date | 2013-04-05 |
| Last Update Date | 2021-09-09 |