| NPI | 1598729550 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 26094) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IA 21979) |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2011-06-14 |