| NPI | 1609872381 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 40732) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WI 41931) |
| Enumeration Date | 2005-06-27 |
| Last Update Date | 2015-06-30 |