| NPI | 1457339079 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 51822) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WI 56055) |
| Enumeration Date | 2006-01-04 |
| Last Update Date | 2025-06-04 |