| NPI | 1861889834 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 71952) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 287418) |
| 207X00000X Orthopaedic Surgery (Licence: WI 82434) | |
| 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: MA 287418) | |
| Enumeration Date | 2015-04-17 |
| Last Update Date | 2023-12-08 |