| NPI | 1881709244 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 75819) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WI 48584-20) |
| 207X00000X Orthopaedic Surgery (Licence: NY 279775) | |
| 207X00000X Orthopaedic Surgery (Licence: VA 0101251731) | |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2024-08-08 |