| NPI | 1689612178 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 41208) |
| Additional Taxonomies | 174400000X Specialist (Licence: MN 41208) |
| 207R00000X Internal Medicine (Licence: MN 41208) | |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2020-10-20 |