| NPI | 1275543688 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WI 24890-20) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA MD00029135) |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2023-08-31 |