| NPI | 1760707293 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD458016) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA MD60532776) |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: WA MD60532776) | |
| Enumeration Date | 2010-03-27 |
| Last Update Date | 2024-03-15 |