| NPI | 1487074142 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: AZ 58108) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA 60475555) |
| 207X00000X Orthopaedic Surgery (Licence: AZ 58108) | |
| Enumeration Date | 2014-04-22 |
| Last Update Date | 2022-09-13 |