| NPI | 1467944306 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 73470) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4301115383) |
| 207X00000X Orthopaedic Surgery (Licence: WI 82605) | |
| Enumeration Date | 2018-06-06 |
| Last Update Date | 2023-11-22 |