| NPI | 1356855688 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 29642) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MD NA) |
| Enumeration Date | 2017-11-22 |
| Last Update Date | 2019-01-09 |