| NPI | 1720540594 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: AL 41897) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA MD61526179) |
| Enumeration Date | 2019-04-02 |
| Last Update Date | 2025-12-08 |