| NPI | 1316649916 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 77465) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 33493) |
| Enumeration Date | 2023-03-20 |
| Last Update Date | 2024-08-04 |