| NPI | 1992408884 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 77514) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 33380) |
| Enumeration Date | 2023-03-22 |
| Last Update Date | 2024-08-29 |