| NPI | 1821843780 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 80349) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 34406) |
| Enumeration Date | 2024-04-23 |
| Last Update Date | 2025-07-30 |