| NPI | 1942393954 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 0101242127) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA MD60864228) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2022-10-25 |