| NPI | 1386104271 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 67731) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 30018) |
| Enumeration Date | 2019-03-25 |
| Last Update Date | 2024-06-27 |