| NPI | 1720440522 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: OR MD210541) |
| Additional Taxonomies | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: WA MD61139102) |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2022-07-06 |