| NPI | 1457466658 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA MD60631095) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OR MD151775) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2022-07-21 |