| NPI | 1285996942 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA MD60834057) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME131520) |
| 207X00000X Orthopaedic Surgery (Licence: KS 9407873) | |
| Enumeration Date | 2012-06-08 |
| Last Update Date | 2022-07-21 |