| NPI | 1811966617 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 44528) |
| Additional Taxonomies | 207XX0801X Orthopaedic Surgery Orthopaedic Trauma (Licence: MN 44528) |
| Enumeration Date | 2006-03-15 |
| Last Update Date | 2020-06-22 |