| NPI | 1326369190 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WI 66118-20) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 60568) |
| 207X00000X Orthopaedic Surgery (Licence: MI 4301096584) | |
| Enumeration Date | 2010-06-16 |
| Last Update Date | 2020-07-23 |