| NPI | 1861841629 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA OS022446) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA OP61136328) |
| Enumeration Date | 2016-06-11 |
| Last Update Date | 2023-01-24 |