| NPI | 1932631488 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 64195) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 28433) |
| Enumeration Date | 2017-04-03 |
| Last Update Date | 2023-08-30 |