| NPI | 1831106756 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA MD60675896) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OR MD21294) |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2021-11-09 |