| NPI | 1770524787 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CT 72607) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA MD00044903) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2022-12-16 |