NPI | 1326457839 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery (Licence: CA A138771) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA MD61054853) |
207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery (Licence: WA MD61054853) | |
Enumeration Date | 2014-08-08 |
Last Update Date | 2024-12-11 |