| NPI | 1447613641 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 71025) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4301503326) |
| Enumeration Date | 2016-04-04 |
| Last Update Date | 2022-06-29 |