| NPI | 1003882515 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA MD00031974) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MD Md00031974) |
| Enumeration Date | 2006-02-24 |
| Last Update Date | 2016-01-05 |