| NPI | 1528401064 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 63589) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WI 69945) |
| Enumeration Date | 2013-04-15 |
| Last Update Date | 2020-08-05 |