| NPI | 1437500261 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 69489) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NE 7724) |
| Enumeration Date | 2016-06-22 |
| Last Update Date | 2021-06-29 |