| NPI | 1891324794 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 69583) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 30900) |
| Enumeration Date | 2020-04-03 |
| Last Update Date | 2021-07-26 |