| NPI | 1629482708 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 67362) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4301105237) |
| Enumeration Date | 2014-06-17 |
| Last Update Date | 2020-07-30 |