| NPI | 1588059521 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA MD61305079) |
| Additional Taxonomies | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: WA MD61305079) |
| Enumeration Date | 2015-04-06 |
| Last Update Date | 2023-10-27 |