| NPI | 1912190075 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: MN 49566) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA MD60158633) |
| 207X00000X Orthopaedic Surgery (Licence: MN 49566) | |
| Enumeration Date | 2007-08-22 |
| Last Update Date | 2019-08-13 |