| NPI | 1912581844 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 71996) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 31763) |
| Enumeration Date | 2021-05-06 |
| Last Update Date | 2022-08-11 |