| NPI | 1841497260 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: HI MD15200) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA MD60904308) |
| 207X00000X Orthopaedic Surgery (Licence: HI 15200) | |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2026-01-21 |