| NPI | 1033418793 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA MD60577172) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 281801) |
| Enumeration Date | 2011-03-21 |
| Last Update Date | 2020-08-16 |