| NPI | 1376905109 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: MA 292226) |
| Additional Taxonomies | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: WA MD61139365) |
| 207X00000X Orthopaedic Surgery (Licence: WA MD61139365) | |
| 207X00000X Orthopaedic Surgery (Licence: MA 292226) | |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2022-08-10 |