| NPI | 1467681932 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 59475) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WI 63850-20) |
| Enumeration Date | 2009-07-06 |
| Last Update Date | 2021-03-11 |