| NPI | 1447948658 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 77551) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 33351) |
| Enumeration Date | 2023-04-26 |
| Last Update Date | 2024-08-09 |