| NPI | 1376730069 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 51694) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WI 52724-021) |
| Enumeration Date | 2007-09-26 |
| Last Update Date | 2015-06-30 |