| NPI | 1013367374 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA MD61336987) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MT211069) |
| 207X00000X Orthopaedic Surgery (Licence: CA A164618) | |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: WA MD61336987) | |
| Enumeration Date | 2016-06-17 |
| Last Update Date | 2022-09-01 |