| NPI | 1750772752 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 68820) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4301110002) |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: MN 68820) | |
| Enumeration Date | 2015-02-11 |
| Last Update Date | 2021-05-10 |