| 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) |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: WI 70087) | |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: MN 73880) | |
| Enumeration Date | 2017-05-04 |
| Last Update Date | 2024-12-24 |