| NPI | 1740290642 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: ID M7323) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA MD00034937) |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2025-07-18 |