| NPI | 1770690687 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: MN 47392) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 47392) |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2025-10-06 |