| NPI | 1407084981 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 59901) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4301094549) |
| Enumeration Date | 2009-06-23 |
| Last Update Date | 2019-06-07 |