| NPI | 1437509387 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: ND 18476) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 79876) |
| 207X00000X Orthopaedic Surgery (Licence: MI 5101022405) | |
| 207X00000X Orthopaedic Surgery (Licence: SC 83559) | |
| Enumeration Date | 2016-06-21 |
| Last Update Date | 2025-06-04 |