| NPI | 1477813731 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 63557) |
| Additional Taxonomies | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: MN 63557) |
| 207X00000X Orthopaedic Surgery (Licence: WI 6114420) | |
| Enumeration Date | 2012-05-21 |
| Last Update Date | 2026-01-30 |