| NPI | 1578727525 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA MD60333186) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MT190936) |
| Enumeration Date | 2008-07-17 |
| Last Update Date | 2013-08-05 |