| NPI | 1477972651 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA MD61152639) |
| Additional Taxonomies | 207XS0106X Orthopaedic Surgery Hand Surgery (Licence: WA MD61152639) |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2021-08-17 |