| NPI | 1710928130 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 70456) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NE 21904) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2021-11-11 |