| NPI | 1518354828 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 69423) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: ME MD23695) |
| Enumeration Date | 2015-04-24 |
| Last Update Date | 2021-08-02 |