| NPI | 1699201038 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 73880) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WI 70087) |
| Enumeration Date | 2017-05-04 |
| Last Update Date | 2023-08-30 |