| NPI | 1346682804 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A133834) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA MD60956312) |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: WA MD60956312) | |
| Enumeration Date | 2013-07-25 |
| Last Update Date | 2023-10-31 |