| NPI | 1750901609 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 69880) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 30945) |
| Enumeration Date | 2020-04-21 |
| Last Update Date | 2021-08-26 |