| NPI | 1477971174 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 67675) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: SC 82211) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: MN 67675) | |
| Enumeration Date | 2014-03-31 |
| Last Update Date | 2020-07-03 |