| NPI | 1699759449 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: KY 41151) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 40786) |
| Enumeration Date | 2005-12-05 |
| Last Update Date | 2024-01-24 |