| NPI | 1760589568 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 58633) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WI 84549) |
| 207X00000X Orthopaedic Surgery (Licence: MN 107710) | |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: KY 39538) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2025-01-24 |