| NPI | 1417952912 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: MN 39160) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 39160) |
| Enumeration Date | 2005-06-20 |
| Last Update Date | 2017-06-26 |