| NPI | 1255744645 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA MD60956750) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NE 28670) |
| Enumeration Date | 2014-06-03 |
| Last Update Date | 2023-05-15 |