| NPI | 1689834327 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 53361) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 20581) |
| 207X00000X Orthopaedic Surgery (Licence: MN 105122) | |
| Enumeration Date | 2008-06-16 |
| Last Update Date | 2011-08-02 |