| NPI | 1548239239 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: HI MD-18902) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA MD00041733) |
| 207X00000X Orthopaedic Surgery (Licence: AZ 46399) | |
| Enumeration Date | 2006-03-15 |
| Last Update Date | 2019-03-15 |