| NPI | 1780887166 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 52645) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 17798) |
| 207X00000X Orthopaedic Surgery (Licence: CA A107192) | |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2011-07-22 |