| NPI | 1124548730 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: ID M-17349) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA MD61260371) |
| Enumeration Date | 2017-06-23 |
| Last Update Date | 2023-07-27 |