| NPI | 1326279597 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 52337) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 104347) |
| Enumeration Date | 2009-08-05 |
| Last Update Date | 2013-06-20 |