| NPI | 1477076065 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 61718) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WI 68144) |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: MN 61718) | |
| Enumeration Date | 2017-07-25 |
| Last Update Date | 2022-07-21 |