| NPI | 1275899635 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA MD60858779) |
| Additional Taxonomies | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: WA MD60858779) |
| 207XX0801X Orthopaedic Surgery Orthopaedic Trauma (Licence: AZ 66323) | |
| 207XX0801X Orthopaedic Surgery Orthopaedic Trauma (Licence: WA MD60858779) | |
| Enumeration Date | 2012-04-10 |
| Last Update Date | 2023-09-27 |