| NPI | 1457983090 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 72120) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 31618) |
| Enumeration Date | 2020-02-11 |
| Last Update Date | 2022-08-25 |