| NPI | 1174817258 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA MD61180938) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OK 28551) |
| 207X00000X Orthopaedic Surgery (Licence: MT 58882) | |
| 207X00000X Orthopaedic Surgery (Licence: MT MED-PHYS-LIC-58882) | |
| 207X00000X Orthopaedic Surgery (Licence: OR MD204587) | |
| Enumeration Date | 2011-06-06 |
| Last Update Date | 2023-12-01 |