| NPI | 1205944303 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: ID M12678) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA MD00047517) |
| 207X00000X Orthopaedic Surgery (Licence: OR MD150231) | |
| Enumeration Date | 2006-08-28 |
| Last Update Date | 2018-03-15 |