| NPI | 1326448770 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA OP61233584)  | 
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MD H91434)  | 
| Enumeration Date | 2014-09-03 | 
| Last Update Date | 2023-03-29 |