| NPI | 1336180413 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA MD60713968) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KY 36058) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2020-07-23 |