| NPI | 1861810103 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA MD61043670) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AL 34894) |
| Enumeration Date | 2014-04-03 |
| Last Update Date | 2020-10-09 |