| NPI | 1639674112 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 65866) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 29160) |
| Enumeration Date | 2018-03-27 |
| Last Update Date | 2024-07-22 |