| NPI | 1487966842 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA OP60953982) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WV 2956) |
| Enumeration Date | 2010-07-13 |
| Last Update Date | 2023-11-03 |