NPI | 1891170577 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL OS15522) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA OP61031159) |
Enumeration Date | 2015-07-23 |
Last Update Date | 2021-07-26 |