| NPI | 1043771397 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MD D0100923) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA MD70010774) |
| Enumeration Date | 2019-03-28 |
| Last Update Date | 2025-10-28 |