| NPI | 1972532240 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: ND 7695) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 39850) |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2021-08-04 |