| NPI | 1659505279 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA MD61107983) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OR MD171472) |
| Enumeration Date | 2009-05-11 |
| Last Update Date | 2025-11-21 |