| NPI | 1689684771 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA MD60661553) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AK 114055) |
| 207X00000X Orthopaedic Surgery (Licence: NE 26594) | |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2022-01-10 |