| NPI | 1669443495 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: MN 36507) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: WI 50227) |
| 207X00000X Orthopaedic Surgery (Licence: WI 50227) | |
| 207X00000X Orthopaedic Surgery (Licence: MN 36507) | |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2026-07-17 |