| NPI | 1073977104 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD479991) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA MD61122990) |
| Enumeration Date | 2016-04-05 |
| Last Update Date | 2024-08-05 |