| NPI | 1063551521 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: TX G5558) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA MD00025517) |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: WA MD00025517) | |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2024-09-10 |