| NPI | 1508823410 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 51578) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OR MD22549) |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2020-12-04 |