| NPI | 1417129339 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OR MD220062) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA MD60925710) |
| Enumeration Date | 2008-03-31 |
| Last Update Date | 2025-03-27 |