| NPI | 1558453944 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA MD00017445) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: HI MD-4727) |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2023-09-27 |