| NPI | 1518303676 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 66054) |
| Additional Taxonomies | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: MN 66054) |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: WA MD60828218) | |
| Enumeration Date | 2013-05-16 |
| Last Update Date | 2021-04-23 |