| NPI | 1326044074 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 37610) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WI 36053) |
| Enumeration Date | 2005-06-27 |
| Last Update Date | 2015-06-30 |