| NPI | 1801393509 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 65887) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 29299) |
| Enumeration Date | 2018-04-09 |
| Last Update Date | 2020-08-25 |