| NPI | 1922334671 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MO 2018045706) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA MD60115825) |
| 207X00000X Orthopaedic Surgery (Licence: CA A122454) | |
| Enumeration Date | 2009-10-29 |
| Last Update Date | 2023-11-29 |