| NPI | 1477505725 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: ND 5831) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 29757) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2021-08-03 |