| NPI | 1447644901 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA MD61081594) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NE 29525) |
| Enumeration Date | 2015-03-23 |
| Last Update Date | 2020-09-21 |