| NPI | 1437237948 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA MD70042507) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WI 25380-020) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2025-11-05 |