| NPI | 1396322210 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 71902) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 31585) |
| Enumeration Date | 2021-03-26 |
| Last Update Date | 2022-08-15 |