| NPI | 1265674071 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: ID M-14024) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA MD60798747) |
| Enumeration Date | 2009-03-26 |
| Last Update Date | 2018-10-16 |