| NPI | 1669735668 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 0101264727) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME131377) |
| 207X00000X Orthopaedic Surgery (Licence: MN 56642) | |
| Enumeration Date | 2012-06-25 |
| Last Update Date | 2020-02-26 |