| NPI | 1679915847 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: UT 11202037-1205) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 58234) |
| Enumeration Date | 2013-07-29 |
| Last Update Date | 2023-11-27 |