| NPI | 1194137968 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA OP60941927) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: ID O-1744) |
| Enumeration Date | 2014-05-28 |
| Last Update Date | 2022-10-17 |