| NPI | 1861596355 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WI 100761) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 50039) |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: MN 50039) | |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2023-08-02 |