| NPI | 1891808473 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OR OR MD15627) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA MD00034589) |
| 207X00000X Orthopaedic Surgery (Licence: CA G53218) | |
| 207X00000X Orthopaedic Surgery (Licence: AK 1986) | |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2025-12-23 |