| NPI | 1437590882 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WI 71635) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 66084) |
| Enumeration Date | 2013-07-15 |
| Last Update Date | 2020-09-16 |