| NPI | 1861472656 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AZ 65052) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: HI md10803) |
| 207X00000X Orthopaedic Surgery (Licence: CA a97027) | |
| 207X00000X Orthopaedic Surgery (Licence: WA MD60145041) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: WA MD60145041) | |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2022-12-01 |