| NPI | 1881670776 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 38069) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AZ 33541) |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: MN 38069) | |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2020-08-20 |