| NPI | 1952693749 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 60425) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WI 73974-20) |
| Enumeration Date | 2011-05-11 |
| Last Update Date | 2023-01-09 |