| NPI | 1326136367 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OR MD14296) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA MD00016126) |
| 207X00000X Orthopaedic Surgery (Licence: CA G34982) | |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2022-02-04 |