| NPI | 1932510468 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA MD61357615) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NE 28669) |
| Enumeration Date | 2014-05-19 |
| Last Update Date | 2023-08-17 |